酒精性肝病患者戒酒失败原因分析  

Reasons of failed alcohol abstinence in patients with alcoholic liver diseases

作　　者：夏洁 张亚飞 李芳[1] 徐思洁 张振华[1] Xia Jie;Zhang Yafei;Li Fang(Department of Infectious Diseases,Second Affiliated Hospital,Anhui Medical University,Hefei 230601,Anhui Province,China)

机构地区：[1]安徽医科大学第二附属医院感染病科,合肥市230601

出　　处：《实用肝脏病杂志》2023年第6期827-830,共4页Journal of Practical Hepatology

基　　金：安徽省自然科学基金资助项目(编号:2108085MH298);安徽医科大学学科建设项目(编号:2021lcxk027);安徽省高校科学研究项目(编号:KJ2021A0323)。

摘　　要：目的探讨酒精性肝病(ALD)患者戒酒失败的原因。方法2021年2月~2022年6月我院诊治的ALD或ALD合并其他肝病男性患者149例,在初次门诊就诊时采取劝戒方法戒酒。采用酒精应用障碍筛查量表(AUDIT)调查,应用二元多因素Logistic回归分析影响戒酒失败的因素。结果在149例ALD患者中,单纯ALD 88例,合并慢性乙型肝炎(CHB)49例,合并其他慢性肝病12例;轻症肝病27例,脂肪肝36例,酒精性肝炎14例和肝硬化/原发性肝癌72例;在随访3个月时,戒酒失败53例(35.6%),戒酒成功96例(64.4%);戒酒成功组年龄、饮酒≥30年、合并肝病和酒精依赖占比分别为(54.8±11.3)岁、56.3%、50.0%和16.7%,与戒酒失败组比[分别为(49.6±11.5)岁、28.3%、24.5%和60.4%],差异显著(P<0.05);戒酒成功组轻症肝病、脂肪肝、肝炎和肝硬化/肝癌占比分别为17.7%、15.6%、6.3%和60.4%,与戒酒失败组(分别为18.9%、39.6%、15.1%和26.4%)比,差异显著(P<0.05);二元Logistic回归分析发现,有酒精依赖、单纯ALD、轻症肝病、脂肪肝和肝炎是影响ALD患者随访3个月时戒酒失败的独立危险因素(P<0.05)。结论超过1/3的ALD或ALD合并其他肝病患者戒酒失败,酒精依赖单纯ALD和病情轻为戒酒失败的独立危险因素,应予以重视。Objective The aim of this study was to investigate the reasons of failed alcohol abstinence in patients with alcoholic liver diseases(ALD).Methods A total of 149 male patients with ALD or ALD with concomitant other liver diseases were admitted to our hospital between February 2021 and June 2022,and all were persuaded and encouraged for alcohol abstinence at first visit.The alcoholic behavior was evaluated by alcohol use disorders identification test(AUDIT),and the univariate and multivariate Logistic analysis was conducted for the factors of alcohol abstinence failure.Results The patients in our series included ALD in 88 cases,with concomitant chronic hepatitis B in 49 cases and with other liver diseases in 12 cases,characterized by mild liver disease in 27 cases,fatty liver in 36 cases,alcoholic hepatitis in 14 cases and liver cirrhosis(LC)or primary liver cancer(PLC)in 72 cases;at the end of three-month of follow-up,the alcohol abstinence failed in 53 cases(35.6%)and succeeded in 96 cases(64.4%);the ages,and the percentages of alcohol abuse longer than 30 yr,with concomitant other liver diseases and alcohol dependence in succeeded patients were(54.8±11.3)yr,56.3%,50.0%and 16.7%,significantly different compared to[(49.6±11.5)yr,28.3%,24.5%and 60.4%]in failed patients(P<0.05);the percentages of mild liver diseases,fatty liver,alcoholic hepatitis and LC/PLC in succeeded patients were 17.7%,15.6%,6.3%and 60.4%,significantly different compared to 18.9%,39.6%,15.1%and 26.4%in failed patients(P<0.05);the multivariate Logistic analysis showed that the alcohol dependence,simple ALD,mild liver diseases,fatty liver and alcoholic hepatitis were the main risk factors for short-term failed alcohol abstinence(P<0.05).Conclusion More than one-third(35.6%)of patients with ALD or ALD with other liver diseases fail to abstain from drinking,and the alcohol dependence ALD alone and mild illness are the independent risk factors for abstinence failure.

关 键 词：酒精性肝病 戒酒 酒精依赖 病情 影响因素 

分 类 号：R575[医药卫生—消化系统]